Kidney Transplantation - Mizrahi

Question 1

Definitions of types of kidney donations

Answer 1

Orthotopic transplantation (liver, heart, lung) - same place as old and removed organ
• Heterotopic transplantation (kidney, pancreas) - new organ in different place, don’t need to remove old organ. Exceptions: PKCD with bloody or infected cysts taking up space of new place. Pancreas is never removed.
• Allogaft - Same species
• Xenograft - diff species
• Isograft - between identical twins (still immunosuppress because of small antigenic differences)
• Autograft - same patient (ureter, parathyroid gland from arm)

Question 2

What are the most problematic antigen/antibody elements in matching a transplant donor and recipient?

Answer 2

HLA
RE

IL-1/2 (Main players in rejection)
T4, T8

PRA (higher if previous transplant, need to use serum in vitro to check percentage)

Crossmatch: serum of recipient antibodies with lymphocyte of donor to prevent hyperacute rejection leading to organ rupture)

Question 3

Preservation time for solid organs

Answer 3

• Kidney : 40+ hours
• Liver: 24 hours
• Pancreas: 16-20 hours
• Heart: 4-6 hours
• Lung: 4-6 hours

Question 4

What are the sources of increased creatinine in transplant?

Answer 4

Compression

Hematoma

Obstruction

Narrowing

Necrosis

Rejection

CsA